Tommy Dickinson. 'Curing queers': Mental nurses and their patients, 1935-74. Manchester: Manchester University Press, 2015. 272 pp. $105.00 (cloth), ISBN 978-0-7190-9588-7.

Reviewed by Ivan Crozier (The University of Sydney)
Published on H-Histsex (December, 2015)
Commissioned by Chiara Beccalossi (University of Lincoln)

In April 2014, The Royal College of Psychiatrists (UK) released a position paper on sexual orientation stating that homosexuality is not a mental disorder and that it therefore could not be “treated” through gay conversion therapies. The College went so far as to consider “that the provision of any intervention purporting to ‘treat’ something which is not a disorder is wholly unethical.”[1] This document was a significant (if overdue) episode in the often fraught history of psychiatric engagement with lesbian, gay, bisexual and transgender (LGBT) people, continuing in line with other important decisions that alleviated the psychiatric oppression of sexual minorities, including the removal of homosexuality from the Diagnostic and Statistical Manual of the American Psychiatric Association in 1973, and from the International Classification of Diseases of the World Health Organisation in 1992 (a lengthy delay that Dickinson attributes to the HIV/AIDS crisis). Numerous other international psychiatric and psychological governing bodies have also stated their opposition to conversion therapies for sexual orientation, finally agreeing to end support for a series of practices that involved nothing less than the psychiatric persecution of LGBT people--although presented as a therapeutic effort to make them “normal.” Now that homosexuality is no longer classified as a mental disorder, it is important to look back into the history of attempts to “cure” people of their sexual orientations and gender presentations, before these treatments are forgotten, and before the people to whom these things were done--and the people who did them--pass away. Tommy Dickinson’s Curing Queers is a big step in this direction.

The history of the psychiatric treatment of the LGBT community is front-loaded. We know a lot about the sexological categorisation of sexual minorities by Richard von Krafft-Ebing, Havelock Ellis, and their colleagues, who created the conceptual apparatuses by which LGBT people were marked as “abnormal” between 1870 and 1920. We know significantly less about how they were treated when incarcerated in psychiatric institutions in the period that followed the establishment of these pathological forms of life, between the ascendency of Freudianism and the changes of attitude towards sexuality of the late 1960s (when some forms of homosexuality were decriminalized in the United Kingdom and the United States, for example).[2] Since Michel Foucault’s History of Sexuality: The Will to Knowledge (1978) it has been commonplace to see medical power operating in the construction of what Ian Hacking calls “kinds of people,” but the exact mechanisms by which this psychiatric power operated once these categories were constructed is much less researched.[3] For this, we are fortunate to have Curing Queers, in which Dickinson builds upon the work of Michael King and his colleagues on the psychiatrists who employed “homosexual aversion therapies” in British mental hospitals.[4] Dickinson’s particular focus is the nurses who administered these treatments (seventeen of whom he interviewed; nine women, eight men, of whom four were gay), while also attending to those who were subjected to them (eight recipients of these treatments, six gay men and two transwomen, were engaged in Dickinson’s research). The result is a rich and nuanced study of one of the low points of British psychiatric history, analyzed through various historiographical lenses including gender, professionalization, queer studies, and nursing history.

Psychiatrists had been trying to change homosexuals since Alfred von Schrenk-Notzing (Germany) and Lloyd Tuckey (England) had claimed some success in luring men away from their most ardent desires, by hypnotizing and then sending them off to consort with female sex workers. Although by the mid-1930s Sigmund Freud had written a letter to an American mother saying that there was little expectation to change the orientation of her homosexual son, psychiatrist Louis Max claimed in 1935 that he had effected a change in the sexual orientation of a homosexual man through the administration of strong electric shocks while his subject was shown arousing homosexual images over a period of three months.[5] This paper was barely noticed until the mid-1950s, when a flourish of new articles appeared about the uses of aversion therapies to “cure” unwanted sexual desires. These did not solely rely on submitting gay men to electric shocks when they showed an arousal response to pictures of naked men; chemical aversions were also employed.

In one of the graphic sections of his book, Dickinson explains the procedure used by psychiatrist Basil James (1962).[6] A forty-year-old man was given an emetic dose of apomorphine and 57ml brandy, repeated at two-hour intervals. “As soon as nausea occurred, a strong light was shone onto a large piece of cardboard on which were pasted several photographs of nude or semi-nude men. The patient was asked to select an attractive image, and recreate the experiences he had had with his current homosexual partner [which was recorded]…. Thereafter the tape recorder was played twice every two hours during the period of nausea” (p. 67). This clinical description derived from James’s account fails to capture the horror of the event, but we can recreate it from the compelling accounts of the inmates and the nurses quoted liberally throughout Dickinson’s book. The whole procedure, as it was employed throughout the 1960s and after, took three or so days per session. The man would have no toilet, nowhere to wash, no change of clothes or bed linen. The images displayed around him were attempting to convert his sexual desires into nightmares. The smell of faeces and vomit and urine was combined with the overwhelming feeling of nausea and the psychological effects of sleep deprivation. Psychiatry was in effect using homosexual desire as a weapon of torture, turning it back on the person who confessed these feelings. And when the man was not feeling sick, he was inundated with (presumably unwanted) sexually enticing images of women who were supposed to arouse him back to the safe shore of heterosexuality. Gay desires became associated with the failure of the body to hold its limits, and were degraded in a deluge of shit and spew and suffering. Heterosexual desire was supposed to make things better, and indeed subjects were believed “cured” when they could convince the hospital staff that they no longer wanted sex with other men, but reported that they were ready to have sex with women instead. The trauma that follows such treatment is the responsibility of the legal-psychiatric system used to regulate sexuality.[7]

The police lock-ups of the 1950s were partly filled with men who had been entrapped while looking for a fleeting moment of sexual satisfaction in a public toilet, only to find that the pretty young man who smiled at them was a police decoy.[8] Some of these men consented to being subjected to aversion therapy in preference to lengthier prison time. What is more disconcerting in Dickinson’s study is that some men, who had no trouble with the law, volunteered for aversion therapies in order to remove their unwanted attraction to other men. Such is the depth to which homophobia sank in the mid-twentieth century, under the guise of making people “normal.” Some homosexual men internalized this social hatred, and would do anything possible to “fit in” to heteronormative society, even check themselves into a psychiatric institution to be “cured” by becoming terrified of their own desires. It does not take Lytton Strachey to see the power that heteronormative bourgeois standards had over individual psyches in the twentieth century. Needless to say, since these practices, the relationship between LGBT people, the police, and psychiatry has been understandably strained. The Royal College of Psychiatrists, as noted above, has recently made some step towards acknowledging these past wrongs; the police are now often seen marching in support at Pride parades, but some traumas take generations to be forgotten.

Dickinson’s book focuses mostly on the nurses who were the mechanisms in the application of this terror. Having provided a solid historical background to the profession of mental nursing, including descriptions of nurses administering other unpleasant and difficult procedures to the mentally ill, Dickinson explains how aversion therapies were applied systematically.[9] It was not the psychiatrists who got their white coats dirty when “sexual deviants” were subjected to these therapies. In order to best institute such abhorrent practices, and to minimize the opportunity of questioning these practices, the work was broken up work into simple elements. One nurse might be ordered to administer an injection of an emetic substance, but would not see the effects of their actions. Another nurse might be told not to comfort the sobbing homosexual covered in his own filth, as it was not a part of the treatment--the psychiatrists in charge made it clear that such suffering was for the patients’ own good in the long run. Yet another nurse would be expected to go on a faux date around the hospital grounds, to assess how the man responded to kindly female attention. It was a system held together by deliberate ignorance and sometimes lies. Although they were directly involved in administering these procedures, nurses lacked substantial power in mental institutions, and Dickinson does much to emphasize that they were “just following orders”--just trying to get on and be good nurses and not resist psychiatric power--by comparing his mental nurses to those nurses who worked as a part of the unethical medical experimentation under the Nazi regime. Sometimes, as is explored in chapter 4, nurses were subversive, and did what little they could to comfort the men in their charge, even if it meant breaking the rules (such as pretending that an incurable homosexual had made a pass at her, and could now go home “cured” rather than undergo another round of “treatment”). Other times, they apparently gained some nasty pleasure from maltreating “sexual deviants” like this. Most typically, they were simply subordinate, got on with their job, and hoped that they were doing no lasting harm (and in the case of gay nurses, hoped that they would not be found out). Dickinson is careful to protect nurses from too great a share of the blame for administering these treatments, which is fair, as it is important to remember that they were the end point of a long legal-psychiatric process.

Dickinson’s strength is his reconstruction of the nursing practices involved in aversion therapies, but his research could be better contextualized by reflecting much more on the legal framework that lay behind the psychiatric treatment of a criminal offense. Dickinson only touches on this legal background in a passage where he describes the 1824 Vagrancy Act and the 1898 Amendment Act on which much of the policing of homosexuality relied.[10] The relevant section reads, “every male person who in any public place persistently solicits or importunes for immoral purposes shall be deemed a rogue and a vagabond and may be dealt with accordingly.” This was a law that was introduced to regulate pimps living off sex workers, but was so vaguely worded that it was able to be used to control homosexuals (the assumption being that homosexuality had some “immoral purpose,” and thus those who might be suspected of homosexuality could be rounded up; it worked in conjunction with the 1885 Law Amendment Act that criminalized sexual acts between men, whether in public or private). Rather than remain in prison for a longer sentence, homosexual men not uncommonly agreed to undergo the therapies described in Dickinson’s book. Many of those interviewed regretted this decision, and explained the unhappy effects on their subsequent lives.

Homosexuality is a medico-legal construct. It was not only psychological theories adapted into practice by Louis Max, Basil James, or their colleagues that led to gay men being treated like this by psychiatrists. Homosexuality was a way of life that brought men into contact with the law.[11] The psychiatrists and mental nurses in Dickinson’s study were not simply treating sick people--when they were involved with aversion therapies, they were acting as a part of a legal-psychiatric system that connected the legal protection of the heteronormative status quo to the specific treatments of individuals in mental hospitals. The police and the prison system acted as a conduit between the law and the psychiatrists. Elsewhere, it has been argued that psychiatric and forensic-medical constructions of homosexuality were initially responses to the law,[12] in that the early medical discourses about homosexuality were either a way of directly supporting legal investigations (as with forensic expertise) or a way of expanding the understanding of the crime as a doubling effect, by adding “a whole series of other things that are not the offense itself but a series of forms of conduct, of ways of being that are … presented in the discourse of the psychiatric expert as the cause, origin, motivation and starting point of the offense.”[13] All discussions of psychiatric constructions of homosexuality need to be keenly aware of the law, which was the key drive behind the pathologization of “sexual aberrations.”

Dickinson’s work has much to recommend it. He not only deals with the history of mental nursing as an important aspect of homosexual therapies; he also keeps an eye on politics and popular culture, following through these debates in the press, and in cinema. His use of press clippings to show how these treatments were presented to the general public is particularly good and will surely be the starting point for much future work in the recent history of LGBTQ life. As unsettling as it is to read the descriptions of what happened to gay men and transwomen when they were subjected to psychiatric “treatments,” Tommy Dickinson has done a great service to LGBT history by uncovering the details of how psychiatry was enrolled in the heteronormative agenda. 

Notes 

[1]. Royal College of Psychiatrists' statement on sexual orientation, http://www.rcpsych.ac.uk/pdf/PS02_2014.pdf (accessed 20 August 2015), 2. An overview of the RCP on LGBT issues is at http://www.rcpsych.ac.uk/members/specialinterestgroups/gaylesbian/submissiontothecofe/psychiatryandlgbpeople.aspx#history (accessed 26 August 2015).

[2]. See Chris Waters, “The Homosexual as a Social Being in Britain, 1945-1968,” Journal of British Studies 51 (2012): 685-710; Chris Waters, “Havelock Ellis, Sigmund Freud and the State: Discourses of Homosexual Identity in Interwar Britain,” in Sexology in Culture: Labelling Bodies and Desires, ed. Lucy Bland and Laura Doan (Chicago, University of Chicago Press, 1998), 165-79.

[3]. Ian Hacking, “Kinds of People: Moving Targets,” Proceedings of the British Academy 151 (2007): 285-318.

[4]. Michael King and Annie Bartlett, “British psychiatry and homosexuality,” The British Journal of Psychiatry 175, no. 2 (1999): 106-113; Michael King, “Treatments of homosexuality in Britain since the 1950s—an oral history: the experience of professionals,” British Medical Journal 328 (2004): 429.

[5]. Louis Max, “Breaking Up a Homosexual Fixation by the Conditional Reaction Technique: A Case Study,” Psychological Bulletin 32 (1935): 734. See Dickinson, Curing Queers, 66. Max used a stronger shock on homosexuals than those which he administered in other laboratory studies on humans.

[6]. Basil James, “A Case of Homosexuality Treated by Aversion Therapy,” British Medical Journal 17 (1962): 768.

[7]. The law has already acknowledged its error in the case of Alan Turing, who was given a posthumous pardon.

[8]. In this, Dickinson builds on the work by Matt Houlbrook. Se, “The Private World of Public Urinals: London, 1918-57,” London Journal 25, (2000): 52-70.

[9]. Such as the cardiazol shock therapy described by Niall Mcrae: “'A violent thunderstorm': Cardiazol treatment in British mental hospitals,” History of Psychiatry 65 (2006): 67-90.

[10]. For more on the policing of homosexuality in Britain, see Harry Cocks, Nameless Offences: Homosexual Desire in the Nineteenth Century (London: IB Tauris, 2003); Matt Houlbrook, Queer London (Chicago: Chicago University Press, 2005); and Matt Cook, London and the Culture of Homosexuality, 1885-1914 (Cambridge: Cambridge University Press, 2003).

[11]. Sex between women was not illegal, and so other social and medical prohibitions were used to regulate it. See Chiara Beccalossi, Female Sexual Inversion: Same-sex Desires in Italian and British Sexology, c. 1870-1920 (Basingstoke: Palgrave, 2012) for detailed attention to this issue between 1870 and 1920.

[12]. Ivan Crozier, “The medical construction of homosexuality and its relation to the law in nineteenth-century England,” Medical History 45 (2001): 61-82.

[13]. Michel Foucault, Abnormal: Lectures at the Collège de France, 1974-1975 (London: Verso, 2003), 15.

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Citation: Ivan Crozier. Review of Dickinson, Tommy, 'Curing queers': Mental nurses and their patients, 1935-74. H-Histsex, H-Net Reviews. December, 2015.
URL: http://www.h-net.org/reviews/showrev.php?id=44552

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